Running with Crohn’s: It’s a Guy Thing II

Not an entry on running or Crohn's

Warning: this entry contains graphics that some might find objectionable.

The prostate biopsy

There are three methods of obtaining a prostate biopsy.  The transrectal and transperineal are the two most common of these (the transurethral biopsy is the third but it isn’t performed as often).

For the transrectal prostate biopsy, the doctor inserts a probe (which includes an ultrasound wand) into the rectum.  He uses the ultrasound to ensure proper sampling of the prostate with the sampling needle.  Different doctors take different numbers of samples (mine took 12 samples).  The doctor also uses the ultrasound to measure the prostate and ensure it had a normal consistency.

Because I have extensive rectal scarring (from fistulas and other Crohn’s related problems), my anus is smaller than typical (and smaller than it used to be).  Therefore, the probe caused me substantial pain, rectal tearing, and bleeding.  In addition, the sampling with the sampling wand was very unpleasant.  Since my father had warned me that the procedure was unpleasant, I had taken the maximum dose of pain medication left over from my kidney stone procedure (2x 5mg/500mg Vicodin).  Although this did not deaden the pain, it made the procedure much less traumatic.  Note to any doctors that might read this blog, please prescribe your prostate biopsy patients two prescription strength painkillers for this procedure – I think those made the process much more tolerable!

The doctor took the biopsy samples by driving a needle through the wall of the rectum and into the prostate.  Each sample hurt pretty badly for me (some people report that taking samples on them is relatively pain-free).

Transrectal biopsy

After the biopsy, expect blood in your urine, ejaculate, and stool.  I continued getting blood in the ejaculate up to a month after the biopsy.  I stopped getting blood in my urine and stool after just a few days.  I found ejaculation somewhat painful for a number of days to perhaps a week.

Prostate biopsy: What to expect 

Both the ultrasound and biospies showed no irregularities in my prostate, so the doctor recommended a follow-up PSA screen in 6-months (August of 2013).